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l <br /> � � I <br /> PERMIT APPLICATION ; <br /> BUILDINGIMECH^NICAUPLUMBING/SIGN/SPRINKLERIDEMOLITION I <br /> CITY C�F EVERETT PER�dIT SERYICFS <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—wvuw.everetiwCa�.o=g p`�' <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM d <br />� SITE ADDRE � PROPERTY TAX N P MJT� _O„/ <br /> / �SO <br /> LEGAL f�r new co��truclion: Sho�t PI ubdivislon Lot No._ (attach copy ol long lagal description) <br /> �� <br /> OWNER PhonelE-mail <br /> Address CitylStele/Zip <br /> �.—� <br /> CONTRACTOR � L 8 I iic.# � � <br /> a�/ - ru�,as� " <br /> Address (N�+ QGVO PhonalEmail � ��� Q8 <br /> TENAN7 BUSINESS CONTACT�OR P�,E�fMIT,�� iJ�L <br /> v�,�.X/ /�.d�'.�Sf �/v�i.,,���.�. <br /> PhonefE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WONK <br /> Existing Use ot Building HFAT SOURCE: <br /> Proposed Use of Building Gas Elearic Other_ <br /> Building lype: _Single Famiiy _Duplex_Townhouse _Multi-Famil _Commercial <br /> Type of projed: _New _Addition _Ramodel _Repair_T.I.�Sign_Sprinkter_Demolition_Change of Use <br /> Descripiion of 1Wofk(edditional space provided on fhe Dack�:� � /'L���� JG� L��� Q'/ `�� <br /> ��!/S('0� J��'(J �/�LP " L// �s�(.K ! <br /> Have you atarted workin�without a pertnit? _YES �NO <br /> MECHANICAL PERMIT APP�_ICATION PLUMBING PERMIT APPLICATION <br /> TypeofProJact: _Naw_Addn _AlunGon_Rapair rypaofPro�xt: _Naw_Atldn _A!braUon_Rep�lr <br /> Show Number(MJ ot flxtums Show Numba(MJ o1 Nxtures <br /> AIC–airhandlin unils Toilet <br /> Forced air s stems Bathtub <br /> Gas pi in Lavato (wash basin) <br /> Waler healer SLower <br /> Gas flreplace Kitchen sink 8 disposal <br /> Gasran e Dishwasher <br /> Clothes d er Cloth=s washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink(servicelbar/mopletc.) <br /> Heat pump Backflow reventer <br /> Unit healer Urinal <br /> Boiler Drinkin Fountain <br /> Refri eretion Floordrain <br /> Woodstove Grease trap <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other. <br /> INumber of Heads Other. <br /> I hereby certiy ihat I have read and examined this appiiwtion and know the same to be lrue and correG.Ali provisions ol laws and ordinances goveming <br /> this type af work vnll be complied vrith whether specified herein or not.The granting of a peimit dces not presume to give authoriry lo�•lolate or cancel <br /> the provision of other state or Iocat lew regulating conslrudion or the peAortnence of construclion.Thal 1 am authorized by Ihe ovmer of this property <br /> to peAorm Ihe ork r which application is made and 1 comply wilh ihe Stale Conlractors Law 1827 RCW and 29820D WAC <br /> OwnerlAu o Agent Slg a 'e Da�e (Reviavd 2/2011)�� <br />